The Clinical Rationale

Altered movement behaviours are habitual and learned — and feel entirely normal to the patient. Appropriately prescribing and retraining functionally useful torso motor control is a therapeutic skill, and the corrective motor patterns are often genuinely difficult for patients to master.

The Key Moves^® Programme provides a progressive series of exercises suited to both one-on-one clinical settings and supervised small group therapeutic exercise classes. The goal is to retrain lost or unlearned movement patterns in a structured, mindful, and clinically purposeful way.

The Key Fundamental Patterns of Movement^® — for the core, pelvis, and shoulder girdle — are taught mindfully, developing breath control, deep inner core activation, and appropriate global muscle engagement. The programme ‘trains the brain to ease the pain’, while simultaneously improving integrated function between the spine, the proximal limb girdles, and the rest of the body. The overarching aim is to improve each client's neuromuscular fitness.

A Note on Clinical Reality

Most patients in clinical practice cannot properly execute more than a few motor control exercises as part of a home routine — they simply cannot feel, or reliably remember, what to do. Exercises addressing stiffness are an easier ask, yet these too can go awry if the patient cannot first master the Key Fundamental motor patterns that underlie effective functional control. Supervision is usually necessary to optimise motor relearning.

How Key Moves^® Was Developed

The Key Moves^® Programme has evolved over time from a convergence of sources: contemporary research; close observation of the posturo-movement dysfunctions most commonly found in spinal and related pain populations; rigorous road-testing of other exercise methodologies; and a thorough grounding in healthy patterns of torso movement control.

That last element has a perhaps unexpected origin. My earlier career as a paediatric physiotherapist — working with the facilitation of normal infant motor development — gave me a foundational understanding of how movement patterns are acquired, established, and lost. That perspective informs every aspect of the Key Moves^® approach.

For Movement Therapists — Pilates, Yoga, and Beyond

The Key Approach^® and Key Moves principles can be incorporated into other exercise and movement disciplines — Pilates, Yoga, Tai Chi, gym-based training — helping to ensure exercise that is spine-safe, rehabilitative, preventative, and genuinely health-promoting.

This matters because in my clinical experience, many prescribed exercise and fitness programmes are inadvertently compounding musculoskeletal problems rather than resolving them. An ill-informed exercise programme can entrench posturo-movement dysfunction and contribute to the onset or perpetuation of spinal pain and seemingly unrelated injuries.

Pilates is currently the dominant paradigm — and while it has undoubtedly helped many people, there are clinically important pitfalls that are frequently underappreciated. Under the Pilates umbrella sit many different approaches, with widely varying content, delivery, and practitioner training. Some patients attending clinical Pilates — or yoga — are doing so at a level that is simply not appropriate for their current functional capacity. The consequences can include increased neck pain and headaches, proximal and limb pain disorders, worsening low back pain, and a range of tendinopathies and other overuse presentations.

(See my published papers: 'The Core' and 'Unravelling Core Stability' for a detailed evidence-based discussion.)

The Key Approach® helps the thinking Pilates or Yoga practitioner address each individual's particular difficulties in a more specific and therapeutic way. It provides:

• A deeper understanding of the causes and drivers of movement dysfunction
• Clinical subgroup identification — clarifying which patients will respond to a more standard approach and which require modification
• Insight into healthy functional control and adaptive motor strategies
• Practical guidance on the cues most likely to improve patient response

Learn More

The Key Moves^® Programme is taught in our series of one-day workshops: Key Moves 4 Spinal Rehab